Provider Demographics
NPI:1780828756
Name:KIMBERLY BOYD COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:KIMBERLY BOYD COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ AO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LINNE
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:832-233-3086
Mailing Address - Street 1:PO BOX 5857
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5857
Mailing Address - Country:US
Mailing Address - Phone:832-233-3086
Mailing Address - Fax:832-201-8229
Practice Address - Street 1:2323 TIMBER SHADOWS DR STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2028
Practice Address - Country:US
Practice Address - Phone:832-233-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18260101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355080803Medicaid